Endocrine Abstracts

The beneficial effects of metabolic surgery on clinical and biochemical parameters in patients with type 2 diabetes are well-described. Laparoscopic sleeve gastrectomy has more recently gained recognition as an effective form of surgery along with laparoscopic gastric bypass. We wished to evaluate the impact on anti-hyperglycaemic medication use and glycaemic control in patients with pre-existing diabetes undergoing surgery by a single surgeon in the country’s highest volume metabolic surgery unit. Between 2008 and 2013, 74 (28%) of 264 (176 gastric bypass and 88 sleeve gastrectomy) patients who underwent surgery had pre-existing diabetes. Mean duration of diabetes was 36 (1–240) months. Forty-six (62%) were female with median age 51 (33–75) years. Pre-operatively, 14 were diet controlled, 50 were on oral hypoglycaemic agents and a further ten were treated with insulin. Mean BMI and HbA1c pre-operatively were 48.6 (±7.0) kg/m² and 62.9 (±18.2) mmol/mol respectively. At a 12-month minimum post-operative follow-up, BMI had fallen to 34.0±6.3 kg/m² (P<0.001) and HbA1c to 45.3±11.7 mmol/mol (P<0.001). Of the 50 patients taking oral medications pre-operatively, 40 were able to discontinue all medications, and of the ten on insulin pre-operatively, seven no longer needed insulin therapy.

Our findings from the largest surgical Irish centre are in keeping with similar published international data and again demonstrate the positive benefit which may be seen in patients with diabetes undergoing metabolic surgery.